HIV drug resistance in HIV positive individuals under antiretroviral treatment in Shandong Province, China

Background: Although the number of new HIV infections continues to decline in Iran, the number of HIV-infected patients aged ≥50 years continues to rise due to the introduction of new treatment and longer survival. The higher prevalence of medical comorbidities and treatment failure in this population is a critical challenge in HIV treatment. In the present study, prevalence of comorbidities, rate of response to treatment, and results of HIV drug resistance tests were explored in older patients. Methods: A cross-sectional study was conducted at a tertiary referral HIV center in Tehran, Iran. The data for all the HIV-positive patients older than 50 years old were collected by reviewing their medical records within the last 15 years. Data included demographic and behavioral characteristics, immunologic and virologic response, rate of treatment failure, and HIV resistance. Results: The records for 100 patients with a mean age of 62.5 (range 50-79) years were reviewed and analyzed. Medical comorbidities were observed in 20% of the patients, with HCV co-infection, diabetes mellitus, and neuropsychiatric impairments being the most common. Complete immunologic and virologic responses were respectively observed in 88 and 97% of patients. The treatment regimen was modified in 66 patients, with drug side effects being the reason in 63 patients (95.4%). HIV drug resistance tests showed a low rate of resistance (<10%) to all drugs used in this population. Conclusion: Our findings highlight the high prevalence of comorbidities in older HIV-positive individuals in Iran. A thorough endocrine and neuropsychiatric assessment at each visit is recommended for these patients. Access to an appropriate psychosocial support system will ensure earlier detection of HIV infection and comorbidities in the older population, and will undoubtedly improve the treatment outcome and quality of life among them.

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HIV Drug Resistance in Antiretroviral Treatment-Naïve Individuals in the Largest Public Hospital in Nicaragua, 2011-2015

PLoS ONE ◽

10.1371/journal.pone.0164156 ◽

2016 ◽

Vol 11 (10) ◽

pp. e0164156 ◽

Cited By ~ 10

Author(s):

Santiago Avila-Ríos ◽

Claudia García-Morales ◽

Margarita Matías-Florentino ◽

Daniela Tapia-Trejo ◽

Bismarck F. Hernández-Álvarez ◽

...

Keyword(s):

Drug Resistance ◽

Public Hospital ◽

Antiretroviral Treatment ◽

Hiv Drug Resistance ◽

Treatment Naïve

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Adding Education to “Test and Treat”: Can We Overcome Drug Resistance?

Journal of Applied Mathematics ◽

10.1155/2015/781270 ◽

2015 ◽

Vol 2015 ◽

pp. 1-19 ◽

Cited By ~ 1

Author(s):

Mo’tassem Al-arydah ◽

Robert Smith

Keyword(s):

Drug Resistance ◽

Mathematical Modelling ◽

Antiretroviral Treatment ◽

Rapid Test ◽

Hiv Positive ◽

Test And Treat ◽

Antiretroviral Drug Resistance ◽

Hiv Epidemic ◽

Antiretroviral Drug ◽

Behaviour Changes

Recent mathematical modelling has advocated for rapid “test-and-treat” programs for HIV in the developing world, where HIV-positive individuals are identified and immediately begin a course of antiretroviral treatment, regardless of the length of time they have been infected. However, the foundations of this modelling ignored the effects of drug resistance on the epidemic. It also disregarded the heterogeneity of behaviour changes that may occur, as a result of education that some individuals may receive upon testing and treatment. We formulate an HIV/AIDS model to theoretically investigate how testing, educating HIV-positive cases, treatment, and drug resistance affect the HIV epidemic. We consider a variety of circumstances: both when education is included and not included, when testing and treatment are linked or are separate, when education is only partly effective, and when treatment leads to drug resistance. We show that education, if it is properly harnessed, can be a force strong enough to overcome the effects of antiretroviral drug resistance; however, in the absence of education, “test and treat” is likely to make the epidemic worse.

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